Cerner Is Consolidating Control of Public-Sector EHR

Cerner and Epic Systems, two competing vendors in the electronic health record (EHR) marketplace, control 85% of all EHR licenses in large hospitals. KLAS Research, who first reported the increasingly duopolistic market, noted that the vast majority of these gains are coming from the public sector.

• Cerner’s biggest windfall was being selected by the Veterans Affairs Department to replace a legacy VistA EHR platform. The project kicked off with a starting budget of $782 million and is slated to gross $10 billion over the next ten years.
• The fallout from Cerner’s growth in the public sector will continue to negatively impact its competitor, Epic Systems. Typically, organizations want to consolidate onto a single EHR platform. This is no exception in the public sector, as evidenced by the VA terminating an existing $624 million contract for Epic’s scheduling platform and replacing it with Cerner’s Millennium scheduling tool.
• Despite the blows domestically, Epic Systems is continuing to experience growth in the public sector outside of the United States. For example, the vendor was awarded a $459 million contract for an EHR system with the Province of Alberta, Canada.

Our Take

• The consolidation of power in the EHR vendor space follows a broader trend across enterprise applications. In the past decade, cloud platforms and SaaS licensing made it easier for new entrants to make gains in the health care or general enterprise application marketplace. However, we are now seeing the incumbent technology giants reclaim ground. These major players have made gains by both acquiring the competition and by leveraging their immense resourced to out innovate smaller firms.
• Even with fewer EHR vendors to choose from, it is always recommended to go through a rigorous vendor selection process as a means of building a business case and establishing leverage at the contract negotiating table.

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